Advancements in Hysteroscopic Diagnosis and Management of Endometritis

Infertility remains a complex clinical challenge, with intrauterine pathologies contributing to a significant percentage of in vitro fertilization (IVF) failures. Chronic endometritis (CE) has gained attention due to its potential association with unexplained infertility and recurrent miscarriage. This review explores the role of hysteroscopy in diagnosing and treating CE. The endometrium undergoes dynamic changes orchestrated by ovarian steroids, and disturbances may lead to CE, characterized by plasma cell infiltration. Diagnosis traditionally relies on histopathologic examination, but hysteroscopy offers real-time imaging, revealing the specific macroscopic alterations associated with CE. However, diagnostic accuracy varies, prompting the need for standardized criteria. CE has been linked to poor reproductive outcomes, emphasizing the importance of effective treatment. Antibiotic therapy is a common approach, with doxycycline as the first-line regimen. Hysteroscopic polypectomy, targeting non-infectious CE, emerges as a promising treatment, demonstrating fertility benefits. The review underscores the significance of hysteroscopy in diagnosing and treating CE, providing insights into its impact on reproductive outcomes in infertile women. Further prospective studies are needed to validate these findings and establish unified diagnostic criteria.